The present invention relates to medical equipment and more particularly to surgical apparatus for suturing organs and tissues with metal staples. The proposed apparatus can find application in oncology for suturing the walls of the pharynx in laryngectomy in case of cancer as well as for suturing organs and tissues in the chest or abdominal cavity, e.g., the tissues of lungs, the stump of the stomach, intestines, and other organs.
Known in the art is a surgical apparatus for suturing organs and tissues with metal staples this known apparatus comprises a hook-shaped frame with a clamp member rigidly connected to the other part of the frame and having on the side facing the frame opening, a flat portion on which are recesses for bending the staple legs. Mounted in the frame for perpendicular travel relative to the above clamp member is a staple head provided with a holder for staples and with a staple pusher. Said staple head and pusher are provided with corresponding drives for their travel relative to the clamp member.
The holder has through slots for accommodation of metal staples therein. Said slots accurately match the recesses provided on the clamp member of the frame. The pusher has lugs corresponding to the holder slots. With the pusher moving toward the clamp member of the frame, the pushing lugs fit into the holder slots and push staples out of them.
Inserted in the staples head is an arresting fork for preventing a tissue or an organ being sutured from slipping out of the apparatus.
When applying the surgical apparatus, a tissue or an organ to be sutured should be between the flat portion of the clamp member and the operating face of the holder opposing said flat portion.
In such a position, the tissue or organ being sutured is inserted through the open lateral mouth of the hooked frame; then the tissue or organ is fixed by the arresting fork. The surgeon actuates the drive of the staple head bringing it closer to the clamp member so that a clearance necessary for suturing is set between the flat portion of the clamp member and the operating face of the holder. Thereafter the suturing of tissues is done by actuating the pusher drive; the lugs of the pusher pass through the holder slots and push the staples thereout; on puncturing the tissues being sutured, the staple legs strike against the recesses provided on the flat portion of the clamp member and are bent, thus suturing the tissues. The tissue portion to be disposed of is cut off, the holder is withdrawn from the clamp member, and the whole apparatus is removed from the operation incision.
A disadvantage of the known apparatus is its limited maneuverability that restricts its application for suturing in areas difficult of access, or for suturing under peculiar conditions when the space is limited for manipulations necessary to prepare the apparatus for the operation. This disadvantage is due to the design of the hooked frame shaped as a hook which permits the positioning of the holder and the clamp member of said frame to tissues being sutured only through the lateral opening of the frame. Whenever such positioning is not possible at all, or involves intolerable injury to the tissues being sutured or to the environmental tissues or organs because of shortage of space required for unimpeded manipulation with the apparatus in the operation cut, the use of the apparatus is actually impossible. Thus, in laryngectomy in cases of cancer with the aid of the known apparatus, the positioning of the clamp member of the frame and the holder under the tumor being operated on is possible only from the side of the chin or the chest which are distant from the suturing site. This is fraught with awkward and complicated manipulations in a limited space between the cutoff tumor and the remaining organs and tissues of the head and neck of a patient, which, moreover, result in tissue injury.